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Loria et al. Hepatoma Res 2016;2:316-22 Hepatoma Research
DOI: 10.20517/2394-5079.2016.27
www.hrjournal.net
Original Article Open Access

Role of contrast-enhanced ultrasound

in the evaluation of vascularization of

hepatocellular carcinoma

Francesco Loria , Giuseppe Loria , Salvatore Basile , Giuseppe Crea , Luciano Frosina , Francesca Frosina
1
3
1
2
1
4
1 Department of Radiology, PO Palmi, ASP 5 Reggio Calabria, 89015 Palmi, Italy
2 Department of Radiology, PO Lamezia Terme, ASP Catanzaro, 88046 Lamezia Terme, Italy
3 School of Medicine, University of Messina, 98124 Messina, Italy
4 School of Medicine, Bio-Medical Campus, 00128 Rome, Italy
Correspondence to: Dr. Francesco Loria, Department of Radiology, PO Palmi, ASP 5 Reggio Calabria, 89015 Palmi, Italy. E-mail: francescoloria956@alice.it
How to cite this article: Loria F, Loria G, Basile S, Crea G, Frosina L, Frosina F. Role of contrast-enhanced ultrasound in the evaluation of
vascularization of hepatocellular carcinoma. Hepatoma Res 2016;2:316-22.
ABSTRACT

Article history: Aim: Early individualization of hepatocellular carcinoma is crucial to obtain good therapeutic
Received: 04-07-2016 results, thanks to several options such as percutaneous therapies, surgical resections and
Accepted: 18-08-2016 transplant. Aim of this study is to evaluate the vascularization of hepatocarcinoma using contrast
Published: 22-11-2016 enhanced ultrasound (CEUS) in comparison with multislice computed thomography (MSCT).
Methods: Between January 2009 and May 2014, 67 patients affected by hepatocarcinoma,
Key words: who presented an overall of 92 nodules, were examined and enrolled in the study. Results:
Contrast-enhanced ultrasound, There was a significant difference in the percentage of comparison of the vascularization
hepatocarcinoma, between the nodules situated at a depth not greater than 9 cm, compared to those studied at
multislice computed thomography a greater depth. In reference to the size of the lesion, the percentage of vascularization to the
CEUS in arterial phase, compared with the MSCT, was 84% in lesions with dimensions equal
or less than 1 cm, 91% in lesions with dimensions included between 1 and 2 cm, and 96% in the
lesions greater than 2 cm. Conclusion: CEUS is a method capable of documenting with very
reliable accuracy the intralesional vascularization of hepatic carcinoma, in a superimposable
manner to the MSCT. However, CEUS also presents some limitations, mainly in relation to
the site of lesions.

INTRODUCTION options such as percutaneous therapies, surgical
resections and transplant. Ultrasound examination
Hepatocellular carcinoma (HCC) is the primitive, and measurements of the levels of alpha-fetus protein
most common malignant tumor of the liver in serum are the main screening options. Several
accounting for 70-84% of hepatic tumors. The early methods have been used to evaluate the intralesional
identification of HCC is very important in obtaining vascularization of hepatic focal lesions. [1-5] Computed
good therapeutic outcomes, thanks to several thomography (CT) is the second most common

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